Questionnaire for the Chinese Teacher

We ask your help in completing the following questionnaire, in order that we may place the student in an appropriate level of Chinese at Loomis Chaffee. This questionnaire will be used for placement purposes only, as the student has already been accepted to our school. This is a confidential statement.

Please submit all questionnaires by May 22. Thank you for your help!

Name of Schoolrequired

School City and Staterequired

Name of Teacherrequired

Language studied

Level (year) of language at present

Present mark

What section is the student in?

Honors Regular Other

If other, please specify:

Number of days class meets per week:

Length of class periods:

Does the class meet for the whole year?

Yes No

If no, please explain:

Name and level of current text(s)

Author, date and editor

How much of this text was completed?

Name of current reader(s)

Author, date and editor

How much of this reader was used?

Are audio-visual materials or online resources used in connection with this course?

In class?

Yes No

In lab?

Yes No

If yes, please list:

To what extent is the target language spoken in class?

Percent (%) by student

Percent (%) by teacher

Check the most accurate descriptor of this student's ability and performance in the present course level:

Speaking

Excellent Good Average Poor

Comments

Written Characters

Excellent Good Average Poor

Comments

Reading Comprehension

Excellent Good Average Poor

Comments

Listening

Excellent Good Average Poor

Comments

How does this student learn and assimilate new language material?

quickly and with ease at a moderate pace other

If other, please explain:

How would you describe this student's attitude specifically in your language classroom?

willing or enthusiastic neutral or indifferent other

If other, please explain:

How does this student speak the target language?

with comfort or accuracy other

If other, please explain:

Please describe this student's writing ability in the target language.

If the student were to write an essay about a simple topic, such as their school, how many characters could they write?

50 100 200 300 or more

Has the student learned to handwrite the Chinese characters or just to use the computer to type the characters. If it is a combination, does the student type or write more?

Handwriting Typing

Handwriting only Typing only Both with more handwriting Both with more typing

Comments

Please tell us what you consider to be the strengths and weaknesses of the student:

For how long have you been this student's teacher?

You agree that by typing your name below, you are electronically signing this form and declaring that the information you have provided is true and accurate.

Teacher Full Namerequired

Daterequired (mm/dd/yyyy)

Please send a confirmation email to the address below*: